Spread in the greater community, staff member infections, facility size and the racial makeup of residents are among the factors associated with COVID-19 cases and deaths in long-term care facilities, according to the results of a Kaiser Family Foundation study released Friday.
“This review of studies informs ongoing efforts to limit preventable infections and deaths in long-term care settings, and may help to identify characteristics of facilities most at risk that could be prioritized for vaccine distribution, staff education and oversight,” the authors wrote.
Although a successful vaccination effort should mitigate the future risk of COVID-19 illness and deaths, the KFF analysis identified several factors placing staff members and residents at risk of highly contagious infections, including coronavirus. The report draws on state-level data from 42 states between April 2020 and January.
Few studies have examined the association between COVID-19 cases and deaths and facility-level characteristics in assisted living communities separately from nursing facilities. One study, looking at data from seven states, found that assisted living communities with a high share of residents who are persons of color have high coronavirus case rates. In addition, the study found that larger assisted living communities are more likely to experience at least one COVID-19 case.
Nine studies that looked at community transmission found an association between community case rates and the likelihood of severity of outbreaks or deaths in long-term care facilities. Some studies identify staff member infections as a likely link between community cases and cases in long-term care facilities.
In looking at patterns in COVID-19 cases and deaths in long-term care facilities, the authors noted that those numbers mirrored overall cases and deaths across the country. New long-term care facility coronavirus cases were highest nationally in December, whereas deaths were highest nationally in April. National data show that both total overall and long-term care facility cases and deaths have been on the rise since September.
Based on early state-level trend data, the authors stated that “it appears that this trend will continue through early 2021, suggesting that the peak in deaths in long-term care facilities is yet to come, and could occur in early 2021.”
More than half of reporting states (21 of 39 states) reported their highest average weekly COVID-19 deaths in long-term care facilities in November and December. States reporting the highest number of COVID-19 community deaths in the spring were clustered in the Northeast, whereas states in the West and Midwest reported their highest number of community deaths in December.
Early data suggest that initial vaccine distribution has been slower than anticipated, and in a recent KFF survey, 20% of people who work in healthcare settings said they would definitely not or probably not get vaccinated.
